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Pharm I ( Melicia) > Hep A&B - EG > Flashcards

Hep A&B - EG Flashcards

1
Q

How is Hep A transmitted?

A

person to person

ingestion

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2
Q

what are the 3 stages of Hep A?

A

incubation: 28 days
acute hepatitis 2-3 wks
convalescence: 9 wks

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3
Q

Signs and sxs for Hep A&B

A

prodrome of anorexia, N/V, malaise, aversion to smoking

Fever, enlarged/tender liver, jaundice

normal to low WBC count, markedly elevated aminotransferases

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4
Q

Tx for Hep A

A

immune globulin

handwashing

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5
Q

When is the vaccine for Hep A typically given?

A

2 doses at 0 mo’s and 6-18 mo’s

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6
Q

When is IVIG indicated and when is it effective to use?

A

when the vaccine is NOT an option

  • post-exposure prophylaxis (dose = 0.02)
  • short-term preexposure coverage < 3 mo’s (dose = 0.02)
  • long-term pre-exposure prophylaxis of <5 mo’s (dose = 0.06)
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7
Q

When should you give post-exposure prophylaxis w/ the vaccine?

A

recent HAV exposure

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8
Q

Who should receive Ig prophylaxis?

A

< 12 mo’s or >40 y/o with one of the following:

  • immunocompromised
  • chronic liver dz
  • underlying medical conditions when vaccine is contraindicated
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9
Q

T or F: Patients who receive at least one dose of the HAV vaccine at least 1 mo prior to exposure do not need preexposure or post-exposure prophylaxis w/ Ig.

A

FACT.

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10
Q

How is Hep B transmitted?

A

sexually, parenterally, perinatally (saliva, semen, vaginal secretions)

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11
Q

What pt population is at high risk for chronic infx and what conditions are they at an increased risk for?

A

infants and children

cirrhosis and hepatocellular carcinoma (25-40% and M>W)

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12
Q

Treatment for Hep B

A

supportive = IVIG for acute exposure

preventative = vacine at 0 mo, 1 mo, 6 mo’s

chronic = interferons, antivirals

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13
Q

T or F: antivirals can be used to treat Hep A and B?

A

FALSE.

NOT used for Hepatitis A

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14
Q

Which vaccines are included in the combination vaccine used in infants for HBV?

A

Hep B + DTaP + HIB = combo vaccine

*complete course beginning after infant is equal to or >6 wks of age

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15
Q

When should infants receive the 1st dose of Hep B vaccine if their mother is HBsAg-positive?

A

w/in first 12 hrs of life, hepatitis immune globulin should also be administered at the same time at a different site

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16
Q

when should Infants w/mother HBsAg status unknown receive the 1st dose of Hep B vaccine?

A

within 12 hrs of birth

17
Q

serologic testing and revaccination may be necessary for which pt’s?

A

pt’s renal impairment 1-2 mo’s after final dose of primary vaccine series

18
Q

contraindications/ADE’s/Interactions

A

hypersensitivity
syncope
dermatologic - angioedema
immunosuppressants - may diminish the therapeutic effect of vaccines (inactivated)

19
Q

Chronic hepatitis B treatment?

A

Chronic: INF and antivirals (Entecovir, Tenofovir)

may require long-term therapy but this could lead to resistance (esp. to lamivudine and telbivudine) w/ less resistance to tenofovir

20
Q

what are some recommendations for a pt w/ HBV?

A 
vaccinate sexual and household contacts
avoid alcohol
milk thistle (not w/antiviral tx)
21
Q

When should a pt w/chronic HBV and HBsAg+ receive immediate tx?

A

if jaundice or decompensation

22
Q

goal of tx for HBV

A

hepatic damage is sustained by ongoing viral replication

suppress w/drug therapy by either immunomodulating agents or antivirals

23
Q

What are 3 agents used to tx chronic HBV?

A

entecavir
tenocavir disoproxil
interferon alpha-2b

24
Q

Entecavir ADE’s

A

lactic acidosis*

HA, fatigue, upper abd pain

25
Q

Tenofovir ADE’s

A

Nephropathy & lactic acidosis *

N, abd pain, fatigue

26
Q

Interferon alpha-2b ADE’s

A

flu-like sxs & cytopenias *

mood disturbances, autoimmune disorders

27
Q

What lab should you monitor for HBV therapy?

A

ALT

28
Q

Adefovir ADEs

A

Renal dysfunction, lactic acidosis

Pharm I ( Melicia) (18 decks)

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